ocr: The German social security system, first pioneered by Bismarck, is one of the most comprehensive in the world.. - Health insurance is compulsory and employer and employee contributions are high. Although most hospitals are run by the "Lander, - I some are still owned by Germany's wealthy churches. Germans are increasingly health-conscious, paying great attention to diet. Millions goon - annual trips to the country's200-plus spas. In the east, many are still suffering from lung diseases caused bypollution.